title: Tendon 'turnover lengthening' technique.
abstract: Tendon defect reconstruction is amongst the most technically challenging areas in hand surgery. Tendon substance deficiency reconstruction techniques include lengthening, grafting, two-stage reconstruction and tendon transfers, however each is associated with unique challenges over and above direct repair. We describe a novel 'turnover lengthening' technique for hand tendons that has successfully been applied to the repair of several cases, including a case of attritional flexor and traumatic extensor tendon rupture in two presented patients where primary tenorrhaphy was not possible. In both cases a good post-operative outcome was achieved, as the patients were happy having returned back to normal activities of daily living such that they were discharged 12 weeks post-operatively. Our technique avoids the additional morbidity and complications associated with grafting, transfers and two stage reconstructions. It is quick, simple and reproducible for defects not exceeding 3-4 cm, provides a means of immediate one stage reconstruction, no secondary donor site morbidity and does not compromise salvage by tendon transfer and/or two-stage reconstruction in cases of failure. To our knowledge no such technique has been previously been described to reconstruct such hand tendon defects.
authors.affiliation: St George's Healthcare NHS Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Cerovac
authors.forename: B H
authors.initials: BH
authors.lastname: Miranda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006230:Hand Injuries / Q000601:surgery; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous / Q000601:surgery; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*
keywords: Hand; Segmental defect; Tendon defect; Tendon gap; Tendon lengthening; Tendon reconstruction